title: EGFR tyrosine kinase inhibitors beyond focal progression obtain a prolonged disease control in patients with advanced adenocarcinoma of the lung.
abstract: BACKGROUND
  Recent data show that EGFR pathway and its inhibition maintain their role after progression of disease during EGFR TKI therapy in NSCLCs. We conducted a retrospective study with the aim of evaluating efficacy and feasibility of prosecution of EGFR TKI therapy beyond focal progression associated to locoregional radiotherapy.
  
  
  METHODS
  We retrospectively analyzed the data of all NSCLC patients treated with EGFR TKIs in our institution from 2004 to 2012. We included in the analysis patients that after a focal disease progression, meant as a single lesion RECIST progression, have been treated with definitive locoregional radiotherapy, associated to continuation of EGFR TKI therapy until further progression.
  
  
  RESULTS
  15 out of 147 patients (10%) satisfied inclusion criteria. The median progression free survival, measured from the date of focal progression until further progression of disease or death by any cause, was 10,9 months (range 3-32 months). The corresponding 6 and 12 months PFS rates were 73% and 33%, respectively.
  
  
  CONCLUSIONS
  The longer disease control observed in our patients suggests that continuation of EGFR TKI beyond focal progression associated to a locoregional treatment is an efficacious therapeutic strategy.
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy. Electronic address: fabcon_84@yahoo.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Conforti
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Catania
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Toffalorio
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Duca
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Spitaleri
authors.affiliation: Division of Pathology, European Institute of Oncology, Milano, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Barberis
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Noberasco
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Delmonte
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Mariacarmela
authors.initials: M
authors.lastname: Santarpia
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzari
authors.affiliation: Thoracic and Sarcoma Oncology Unit, Division of New Drug Development and Clinical Pharmacology, Medical Oncology Department, European Institute of Oncology, Milano, Italy.
authors.forename: Tommaso Martino
authors.initials: TM
authors.lastname: De Pas
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018450:Disease Progression; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors
keywords: Advanced lung adenocarcinoma; Beyond progression; Erlotinib; Gefitinib; Lung adenocarcinoma; Radiotherapy; TKI therapy